Incorrect position of Essure microinserts 3 months after successful bilateral placement.
OBJECTIVE
To describe incorrect positions of Essure microinserts detected at 3 months' follow-up.


METHODS
Case report.


METHODS
Outpatient department of obstetrics and gynecology in a Dutch teaching hospital.


METHODS
Initial series of 100 patients who underwent hysteroscopic sterilization using Essure between December 2003 and June 2004.


METHODS
Hysteroscopic placement of the Essure System, follow-up at 3 months with transvaginal ultrasound (TVU), and hysterosalpingography.


METHODS
Bilateral placement rate, tubal obstruction, and detection of incorrect Essure microinsert localization at follow-up after apparent successful bilateral placement.


RESULTS
Bilateral placement of Essure microinserts in one session was successful in 93 women (93%). In 90 of these women (96.8%), tubal obstruction was proven at follow-up 3 months later. Three incorrect positions of an Essure insert were seen: two expulsions and one perforation into the abdominal cavity.


CONCLUSIONS
Incorrect position of Essure microinserts was seen only when the initial placement procedure was difficult. When a placement procedure was difficult or other suboptimal conditions are present during the procedure, we advise performing a TVU or pelvic X-ray in these women 4 weeks after the procedure or after the first vaginal bleeding, instead of waiting for follow-up after 3 months.
Gerritse
Maria B E
MB
University Medical Center, Utrecht, The Netherlands.
Veersema
Sebastiaan
S
Timmermans
Anne
A
Brölmann
Hans A M
HA
D000328:Adult; D003274:Contraceptive Devices, Female / Q000009:adverse effects*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007047:Hysterosalpingography; D015907:Hysteroscopy; D008875:Middle Aged; D011446:Prospective Studies; D012421:Rupture; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography